Mariateresa Moretti

Title: Genitourinary Syndrome of Menopause: Pelvic Floor Hypertonicity and Physiotherapeutic Management of Genitourinary Pain

Abstract

Genitourinary syndrome of menopause (GSM) is a common condition characterized by vulvovaginal and urinary symptoms such as dryness, burning, dyspareunia, and urinary urgency, with a significant impact on quality of life. Traditionally attributed to estrogen deficiency and the resulting mucosal alterations, GSM may also present with pain and dysfunction even in the absence of significant vaginal atrophy. Recent clinical evidence suggests that pelvic floor hypertonicity may represent a relevant co-factor in painful genitourinary conditions, contributing to increased vaginal stiffness, pain modulation, and the onset of functional urinary symptoms. Recognition of this muscular component opens new therapeutic perspectives, in which pelvic floor physiotherapy plays a central role.